TY - JOUR
T1 - Differences in the gait characteristics of people with diabetes and transmetatarsal amputation compared with age-matched controls
AU - Mueller, Michael J.
AU - Salsich, Gretchen B.
AU - Bastian, Amy J.
N1 - Funding Information:
This work was supported by the National Institutes of Health grant HD 31486-01, National Center for Medical Rehabilitation Research. The authors thank Tina Elsner for her extensive help in data collection and data reduction.
PY - 1998/5/1
Y1 - 1998/5/1
N2 - Although qualitative reports in the surgical literature suggest that people with diabetes mellitus (DM) and transmetatarsal amputation (TMA) walk well with regular shoes and a toe-filler, recent data indicates that this population has multiple complications and difficulty with functional mobility. A thorough description of their gait characteristics may provide insights to the cause of these difficulties. The purpose of this study was to compare selected gait characteristics of people with DM and TMA to age-matched controls. We studied 15 subjects with DM and a TMA, and 15 age-matched controls with an overall mean age of 62.3 ± 9.2 years. Data were collected with computer assisted video as subjects walked across a force platform. Range-of-motion (ROM), moments, and power were estimated at the ankle, knee, and hip in the sagittal plane using standard link-segment methods. People with DM and TMA had decreased ROM excursion, peak moments, and peak power at the ankle. At the hip, people with DM and a TMA had decreased ROM excursion, an earlier onset of the hip flexor moment, but no differences in peak moments or peak power. Since people with DM and TMA have reduced ability to generate plantar flexor power at the ankle, they appear to rely more heavily on 'pulling' their leg forward from the hip using their hip flexor muscles. This compensation is not complete, however, as people with DM and a TMA take shorter steps and walk slower than controls. Additional research is needed to determine methods to improve or better compensate for these gait deviations during late stance phase.
AB - Although qualitative reports in the surgical literature suggest that people with diabetes mellitus (DM) and transmetatarsal amputation (TMA) walk well with regular shoes and a toe-filler, recent data indicates that this population has multiple complications and difficulty with functional mobility. A thorough description of their gait characteristics may provide insights to the cause of these difficulties. The purpose of this study was to compare selected gait characteristics of people with DM and TMA to age-matched controls. We studied 15 subjects with DM and a TMA, and 15 age-matched controls with an overall mean age of 62.3 ± 9.2 years. Data were collected with computer assisted video as subjects walked across a force platform. Range-of-motion (ROM), moments, and power were estimated at the ankle, knee, and hip in the sagittal plane using standard link-segment methods. People with DM and TMA had decreased ROM excursion, peak moments, and peak power at the ankle. At the hip, people with DM and a TMA had decreased ROM excursion, an earlier onset of the hip flexor moment, but no differences in peak moments or peak power. Since people with DM and TMA have reduced ability to generate plantar flexor power at the ankle, they appear to rely more heavily on 'pulling' their leg forward from the hip using their hip flexor muscles. This compensation is not complete, however, as people with DM and a TMA take shorter steps and walk slower than controls. Additional research is needed to determine methods to improve or better compensate for these gait deviations during late stance phase.
KW - Amputation
KW - Diabetes
KW - Foot
KW - Human
KW - Walking
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U2 - 10.1016/S0966-6362(98)00015-0
DO - 10.1016/S0966-6362(98)00015-0
M3 - Article
AN - SCOPUS:0032077606
SN - 0966-6362
VL - 7
SP - 200
EP - 206
JO - Gait and Posture
JF - Gait and Posture
IS - 3
ER -